Diagnostic Utility of MRI and MR Arthrography for Detection of Ligamentum Teres Tears: A Retrospective Analysis of 187 Patients With Hip Pain

Abstract

Hip MRI is equally suited for diagnosis of complete ligamentum teres tears when compared with MR arthrography. By contrast, for partial or degenerative ligamentum teres tears, MR arthrography offers the advantage of better arthroscopic correlation.

Usefulness of MR arthrography of the hip with leg traction in the evaluation of ligamentum teres injuries

“…MR imaging demonstrated sensitivities and specificities of respectively 50 and 34 % for the identification of any pathologic process in the LT and 91 and 9 % for partial tears [13]. In a retrospective study of 187 patients, Datir et al [14] correlated MR imaging and MR arthrography with arthroscopy and showed that MR arthrography is more sensitive (89 %) and specific (93 %) than conventional MR imaging (41 and 75 %, respectively) for the diagnosis of partial LT injury. For the diagnosis of complete tears, no statistically significant difference between MR (67 % sensitivity and 99 % specificity) and MR arthrography (67 % sensitivity and 100 % specificity) was found [14].…”

“…Botser reported a sensitivity of less than 2 % in the diagnosis of tears through magnetic resonance arthrography (MRA) as well as positive and negative predictive values of 56 and 49 %, respectively; however, the MR imaging studies reported in that publication were performed at multiple centers using different protocols and without specific attention to the evaluation of the LT. Increased awareness of LT injuries together with technological advances have led to a significant improvement in the diagnostic performance of MR imaging [12][13][14][15] (Table 4).…”

“…In a retrospective study of 187 patients, Datir et al [14] correlated MR imaging and MR arthrography with arthroscopy and showed that MR arthrography is more sensitive (89 %) and specific (93 %) than conventional MR imaging (41 and 75 %, respectively) for the diagnosis of partial LT injury. For the diagnosis of complete tears, no statistically significant difference between MR (67 % sensitivity and 99 % specificity) and MR arthrography (67 % sensitivity and 100 % specificity) was found [14]. In a retrospective study conducted by Chang et al [15] of 165 cases studied using MR arthrography with posterior arthroscopy treatment, MR arthrography demonstrated a sensitivity, specificity and diagnostic accuracy for LT injuries of 78, 97 and 95 %, respectively [15].…”

“…The MR diagnosis of partial LT tears appears to be especially challenging. Recent articles examining LT injuries in 3-T MR imaging and MR arthrography indicate that these modalities demonstrate better diagnostic performance for the assessment of LT injuries [12][13][14][15].…”

Hip Imaging in Athletes: Sports Imaging Series

“…Complete tears are most commonly located near the fovea and show a discontinuity of the ligament with lax contours (Fig 14) (130,137). MR imaging (67% sensitivity, 99% specificity) and MR arthrography (67% sensitivity, 100% specificity) show similar good results for the detection of complete tears, with hip arthroscopy as reference standard (139). However, MR arthrography offers a better diagnostic performance compared with MR imaging regarding partial tears (139).…”